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Infections raise mortality risk in women following CABG.

Higher rates of infection are the primary cause of the increased mortality risk observed in women during the months after cardiac surgery, according to the results of a recent retrospective study.

A cohort analysis found that women hospitalized for coronary artery bypass graft (CABG) surgery were 60% more likely than were men to have an infection during their hospitalization: Sixteen percent of women had infections, compared with 10% of men.

The 14% mortality risk in the 100-day period after CAGB surgery that was deemed to be attributable to female sex decreased to 0.3% after adjustment for infection (Arch. Intern. Med. 2006;166:437-43).

"Therefore, 96% of the sex effect on 100-day mortality could be explained by the underlying differences in infection in this population," explained the researchers.

Mary A. M. Rogers, Ph.D., of the University of Michigan in Ann Arbor, Mich., and her associates evaluated the prevalence of infection in 9,218 Michigan Medicare patients aged 65 years or older who were hospitalized during 1997-1998 for CAGB surgery.

The researchers followed the patients for 100 days after surgery to assess mortality.

Patients with infections were three times more likely to die while in the hospital than were patients without infections, with in-hospital mortality of 12% and 4%, respectively.

In the 100 days after surgery, 17% of patients with infections died, compared with 6% of those without infections.

"The predominance of infection in women was evident across age, race, and other subgroups of patients, as well as across various infection sites," the investigators noted.

With the available data, they were unable to determine whether the infections emerged prior to, or during, hospitalization.

Women were more likely to have infections, but men with infections had a threefold higher relative risk of mortality than did men without infections, while women with infections had a 1.8-fold higher mortality risk than did women without infections.

Infections of the respiratory tract, urinary tract, digestive tract, skin, and subcutaneous tissue were all significantly more common in women than in men. Infections related to internal devices, implants, and grafts occurred at a similar rate in men and women, as did septicemia.

The researchers suggested that these findings should be investigated in a more recent data set and one that contains more detailed information on clinical predictors of mortality.


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Title Annotation:Clinical Rounds
Author:Tanzola, Melinda
Publication:OB GYN News
Date:Apr 15, 2006
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